Academic journal article The Future of Children

Prevention and Drug Treatment

Academic journal article The Future of Children

Prevention and Drug Treatment

Article excerpt

For much of the past century of U.S. public involvement in the protection and care of abused and neglected children, the problem of parental alcohol and other drug abuse (AODA) was hidden, at least from the public's eye. Even though insobriety, alcoholism, and drug addiction have long been recognized as serious family problems by front-line workers and duly noted in case records and service plans, it was only after these afflictions manifested themselves tangibly in physical battery, sexual abuse, lack of supervision, and child abandonment that officials would invoke their authority to intervene in the private affairs of the family. It was this tangible evidence of child maltreatment that was usually recorded and reported as the reason for investigations, court petitions, and child removals. The scale of the underlying AODA problem remained largely hidden in the shadows from public sight.

Several trends during the mid-1980s and 1990s helped to bring about greater public awareness of the AODA connection to child maltreatment and foster care. The first was the change in the gender profile of users from disproportionately males and fathers to increasingly females and mothers. Public officials may have been able to turn a blind eye when it was mostly fathers who returned home drunk or stoned; it was quite another matter when female caregivers increasingly numbered among the users.

Second, the spread of illicit drugs, particularly "crack" cocaine in inner-city neighborhoods, alarmed public officials, who predicted dire consequences for crime, welfare dependency, and public health. (1) Even though the detrimental effect of fetal alcohol syndrome had been well established, the uncertain effects of intrauterine exposure of infants to cocaine, heroin, and other hard drugs prompted hospital officials to increase the number of toxicology screenings at birth. In some states, a positive finding from such a test provided sufficient grounds for filing a child abuse report.

Finally, the shift from a "rights" to a "norms" perspective in federal and state income assistance and child welfare programs (2) helped to enlarge the scope of public interest beyond a narrow focus on child safety to a more diffuse concern with parental responsibility and child well-being in general. Although it is arguable whether parental substance abuse provides a legitimate basis in its own right for protective intervention and child removal, the greater acceptance of government's role in enforcing mainstream parental fitness standards (3) has enlarged the scope of public interest in AODA as a child welfare concern.

These changes in gender profile, hospital surveillance practices, and scope of public interest affect the ways in which researchers classify, make connections, and speculate about cause and effect in the prevention, treatment, and control of parental substance abuse. In this article we examine the magnitude of the AODA problem under different definitions of drug use and at various stages of child protective services (CPS) action, from maltreatment investigation and family case opening to child removal and placement into foster care. We first address the association between parental substance abuse and child maltreatment and the strength of any causal connection between the two. That is, we address the extent to which substance abuse, per se, elevates the risk for child maltreatment and how a link between the two may reflect other causal influences. We review empirical evidence on the extent to which prevention and intervention programs successfully reduce drug abuse, on whether family services help addicted parents control substance use and improve their parenting, and on how well drug treatment programs reinforce sobriety so that foster children can safely be returned to parental custody. For two reasons, we focus our discussion on experiences in the state of Illinois. First, in 1989 Illinois became one of the first states in the nation to approve legislation making intrauterine exposure to illicit substances, by itself, evidence of child abuse and neglect. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.